Opt-in Form, script, MySQL for simple quiz

Wouldn’t you like to know what your natural tendencies are when it comes to disagreements? I want to share that with my Wordpress blog readers. I need a simple combination of opt-in form, script and MySQl database that will let visitors:

Come to my homepage or any page of the site see the graphic form

Enter their full name, email and status into an opt in form

Be redirected to webpage that has quiz on it

Complete quiz and submit

Test taker gets immediate results

Script tallies totals for each question and calculates the style based on highest total